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Running with Metatarsalgia: Tips to Beat the Pain

by Patty Weasler, RN May 18, 2021 0 Comments

If you’re experiencing pain from metatarsalgia, running is generally not recommended to keep because of the high impact it puts directly on your ball of the foot, midfoot, and forefoot. However, if you’re trying to prevent foot pain or you are in the final stages of recovery, you might be wondering how to start (or get back to) a safe running routine. Keep scrolling for the best tips when running with metatarsalgia.

How Running Aggravates Metatarsalgia Pain

Running puts a significant amount of strain through the metatarsal heads, particularly at the big toe. Each time you shift your weight into the front of your foot to push yourself forward, the toes must absorb the impact to keep you moving in a forward direction. This can cause or aggravate the pain associated with metatarsalgia.

The impact the metatarsals endure has been magnified by the rise of barefoot running the past decade among runners. While there are many benefits to barefoot running with adequate training and attention to mechanics, it also comes with a risk of metatarsalgia and stress fracture.

11 Tips For Metatarsalgia When Running

1. Wear the right running shoes

Choose a shoe with a toe box that is wide enough for your toes to spread out comfortably. For a flat or neutral foot, find a shoe with adequate cushioning in the midfoot (sometimes referred to as a metatarsal pad). If you have a high arch, consider shock absorbing support for the arch. Plus, when you aren’t running, don’t forget to avoid tight fitting shoes and high heels.

2. Try Tape or Orthotics

If you can't seem to find the right support with your shoes or need quick short term relief without investing in new shoes, consider taping or shoe inserts like metatarsal pads, insoles and orthotics. These can provide support to the foot and surrounding ligaments while retraining muscles to better coordinate with your higher impact activities. Finding the right insoles can help compensate for existing foot conditions that can aggravate metatarsalgia like plantar fasciitis, flat feet or high arches.

Learn How to Tape for Metatarsalgia

Choosing the Best Insoles

3. Strengthen the intrinsic muscles of the foot

When the muscles within the foot are strong and supple with a proper foot strengthening program, they help support the arch and foot mechanics with weight bearing activity. This means a decreased chance of overpronation and increased dynamic arch support. When the muscles can coordinate correctly, it allows for proper weight distribution across the metatarsal heads and entire foot to reduce potential strain.

Try These Exercises for Metatarsal Pain

4. Strengthen the entire lower chain

Good running technique comes from adequate coordination and strength throughout the spine and legs. Make sure you have a comprehensive core and hip strengthening program that you complete regularly. Balance exercises are a great way to boost strength and coordination at once.  Check out this balance exercise routine from one of our favorite certified personal trainers.

5. Stretch problem areas often

Metatarsalgia is often associated with tight calves. This puts excessive strain on the midfoot with running and can even lead to bunions. Stretch the calves and any other tight muscles that are affecting your running mechanics. Try stretching before and after running if you suffer from stiff ankles or legs. Otherwise, save your stretching for after your run.

Find Metatarsalgia Stretching Exercises Here

6. Crosstrain to give your feet a break regularly

Metatarsalgia is most often due to repetition and overuse. Try adapting to a cross training style of working out with lower impact exercise at least a few times per week. This gives your feet and other joints a frequent break from the constant impact of running on your feet. Some great options include cycling, walking, swimming and even stationary cardio.

7. Choose softer surfaces for running

Running on more forgiving surfaces can reduce the impact on your feet and entire lower body and spine. Try trading in cement for asphalt or rubber rice. Trail running on dirt can also be a great option if your legs can tolerate uneven surfaces. Some newer treadmills even have a soft surface mode.

8. Formally assess your running biomechanics

A trained movement professional, like a physical therapist, can give you a ton of insight into how your running mechanics are affecting your feet. Any dysfunction in the lower body chain can have major repercussions for shock absorption in the feet. You could be experiencing issues in your spine, hips, knees, or ankles that you don’t realize is causing or aggravating your foot pain.

9. Treat your symptoms immediately

As soon as you start noticing something is off, it’s always best to take the time to address your symptoms so that they don’t get worse. Ignoring pain signals from your body is never a good idea since it can lead to chronic issues or even morton’s neuroma. Good home treatment options include grabbing an ice pack, giving the bottom of your foot (the plantar side) a massage, taking it easy for a little while, and considering anti-inflammatory medications.

Treating Metatarsalgia Symptoms

10. Talk to your physical therapist

Outside of running mechanics, a physical therapist can also provide you with pain management tips and education to help you truly understand what’s going on with your feet. You can work with your physical therapist to design a comprehensive home program to treat and help prevent future issues in your feet and other troublesome areas.

11. Talk to your doctor

If you can’t seem to get the relief you want within a week or two, it’s time to talk to your doctor. If you have a podiatrist, even better. They can recommend other treatment options and prescribe medication. Plus, they can assess your foot to rule out other possible issues like stress fractures, gout, and more.

Start Running with Less Foot Pain

If you experience frequent flare ups of foot pain, it’s time to tune in and get to the true underlying cause. Follow the steps above to prevent unnecessary strain. This means quicker healing time, less down time, and fewer issues in the long term. Running can be a great form of regular exercise as long as you keep these simple tips in mind.


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Patty Weasler, RN
Patty Weasler, RN

Patty Weasler is a freelance health writer and nurse. She is certified in critical care nursing and has been practicing for over 10 years. Patty lives in Milwaukee, WI with her husband and three children. She enjoys spending her time with family and educating people about their health.

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